EP2897538B1 - Instrument chirurgical muni d'un ensemble actionneur à double hélice - Google Patents

Instrument chirurgical muni d'un ensemble actionneur à double hélice Download PDF

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Publication number
EP2897538B1
EP2897538B1 EP13774849.7A EP13774849A EP2897538B1 EP 2897538 B1 EP2897538 B1 EP 2897538B1 EP 13774849 A EP13774849 A EP 13774849A EP 2897538 B1 EP2897538 B1 EP 2897538B1
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EP
European Patent Office
Prior art keywords
articulation
rotation
end effector
shaft
knob
Prior art date
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Active
Application number
EP13774849.7A
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German (de)
English (en)
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EP2897538A1 (fr
Inventor
Barry C. Worrell
Jason R. Lesko
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Ethicon LLC
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Ethicon LLC
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Priority claimed from US13/622,735 external-priority patent/US9545253B2/en
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Publication of EP2897538A1 publication Critical patent/EP2897538A1/fr
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • A61B18/1447—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod wherein sliding surfaces cause opening/closing of the end effectors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00318—Steering mechanisms
    • A61B2017/00323—Cables or rods
    • A61B2017/00327—Cables or rods with actuating members moving in opposite directions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2946—Locking means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
    • A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws

Definitions

  • a variety of surgical instruments include a tissue cutting element and one or more elements that transmit RF energy to tissue (e.g., to coagulate or seal the tissue).
  • tissue e.g., to coagulate or seal the tissue
  • ENSEAL® Tissue Sealing Device by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio.
  • Further examples of such devices and related concepts are disclosed in U.S. Pat. No. 6,500,176 entitled “Electrosurgical Systems and Techniques for Sealing Tissue," issued December 31, 2002; U.S. Pat. No. 7,112,201 entitled “Electrosurgical Instrument and Method of Use," issued September 26, 2006; U.S. Pat. No. 7,125,409 , entitled “Electrosurgical Working End for Controlled Energy Delivery,” issued October 24, 2006; U.S. Pat. No.
  • a variety of surgical instruments include a shaft having an articulation section, providing enhanced positioning capabilities for an end effector that is located distal to the articulation section of the shaft.
  • Examples of such devices include various models of the ENDOPATH® endocutters by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio.
  • Further examples of such devices and related concepts are disclosed in U.S. Pat. No. 7,380,696 , entitled "Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism," issued June 3, 2008; U.S. Pat. No. 7,404,508 , entitled “Surgical Stapling and Cutting Device,” issued July 29, 2008; U.S. Pat. No.
  • US 2011/0208211 A1 discloses an articulating endoscopic surgical clip applier which includes a handle assembly and a shaft assembly extending therefrom.
  • the shaft assembly includes an articulating neck and an end effector.
  • the housing has an articulation dial supported therein.
  • the dial is keyed to a tubular screw body which has a pair of oppositely extending helical grooves formed in an outer surface thereof.
  • a pair of opposed articulation cuffs have a respective thread portion formed on an inner surface thereof for slidable receipt in a respective one of the pair of helical grooves.
  • Each cuff is secured to a proximal end of a respective articulation cable.
  • FIGS. 1-4 show an exemplary electrosurgical instrument (10) that is constructed and operable in accordance with at least some of the teachings of U.S. Pat. No. 6,500,176 ; U.S. Pat. No. 7,112,201 ; U.S. Pat. No. 7,125,409 ; U.S. Pat. No. 7,169,146 ; U.S. Pat. No. 7,186,253 ; U.S. Pat. No. 7,189,233 ; U.S. Pat. No. 7,220,951 ; U.S. Pat. No. 7,309,849 ; U.S. Pat. No. 7,311,709 ; U.S. Pat. No. 7,354,440 ; U.S. Pat. No.
  • electrosurgical instrument (10) is operable to cut tissue and seal or weld tissue (e.g., a blood vessel, etc.) substantially simultaneously.
  • electrosurgical instrument (10) operates similar to an endocutter type of stapler, except that electrosurgical instrument (10) provides tissue welding through application of bipolar RF energy instead of providing lines of staples to join tissue.
  • electrosurgical instrument (10) may have various structural and functional similarities with the ENSEAL® Tissue Sealing Device by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio.
  • electrosurgical instrument (10) may have various structural and functional similarities with the devices taught in any of the other references that are cited. To the extent that there is some degree of overlap between the teachings of the references cited herein, the ENSEAL® Tissue Sealing Device by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio, and the following teachings relating to electrosurgical instrument (10), there is no intent for any of the description herein to be presumed as admitted prior art. Several teachings below will in fact go beyond the scope of the teachings of the references cited herein and the ENSEAL® Tissue Sealing Device by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio.
  • Electrosurgical instrument (10) of the present example includes a handpiece (20), a shaft (30) extending distally from handpiece (20), and an end effector (40) disposed at a distal end of shaft (30).
  • Handpiece (20) of the present example includes a pistol grip (22), a pivoting trigger (24), an activation button (26), and an articulation control (28).
  • Trigger (24) is pivotable toward and away from pistol grip (22) to selectively actuate end effector (40) as will be described in greater detail below.
  • Activation button (26) is operable to selectively activate RF circuitry that is in communication with end effector (40), as will also be described in greater detail below.
  • activation button (26) also serves as a mechanical lockout against trigger (24), such that trigger (24) cannot be fully actuated unless button (26) is being pressed simultaneously. Examples of how such a lockout may be provided are disclosed in one or more of the references cited herein. It should be understood that pistol grip (22), trigger (24), and button (26) may be modified, substituted, supplemented, etc. in any suitable way, and that the descriptions of such components herein are merely illustrative. Articulation control (28) of the present example is operable to selectively control articulation section (36) of shaft (30), which will be described in greater detail below. Various examples of forms that articulation control (28) may take will also be described in greater detail below, while further examples will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • Shaft (30) of the present example includes an outer sheath (32) and an articulation section (36).
  • Articulation section (36) is operable to selectively position end effector (40) at various angles relative to the longitudinal axis defined by sheath (32).
  • end effector (40) is operable to selectively position end effector (40) at various angles relative to the longitudinal axis defined by sheath (32).
  • articulation section (36) and other components of shaft (30) may take will be described in greater detail below, while further examples will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • various components that are operable to actuate articulation section (36) may extend through the interior of sheath (32).
  • shaft (30) is also rotatable about the longitudinal axis defined by sheath (32), relative to handpiece (20), via a knob (34).
  • knob (34) is operable to rotate end effector (40) without rotating any portion of shaft (30) that is proximal of articulation section (36).
  • electrosurgical instrument (10) may include one rotation control that provides rotatability of shaft (30) and end effector (40) as a single unit; and another rotation control that provides rotatability of end effector (40) without rotating any portion of shaft (30) that is proximal of articulation section (36).
  • Other suitable rotation schemes will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • rotatable features may simply be omitted if desired.
  • End effector (40) of the present example comprises a first jaw (42) and a second jaw (44).
  • second jaw (44) is substantially fixed relative to shaft (30); while first jaw (42) pivots relative to shaft (30), toward and away from second jaw (42).
  • actuators such as rods or cables, etc.
  • first jaw (42) pivots relative to shaft (30), toward and away from second jaw (42).
  • actuators such as rods or cables, etc.
  • first jaw (42) may extend through sheath (32) and be joined with first jaw (42) at a pivotal coupling (43), such that longitudinal movement of the actuator rods/cables/etc. through shaft (30) provides pivoting of first jaw (42) relative to shaft (30) and relative to second jaw (44).
  • jaws (42, 44) may instead have any other suitable kind of movement and may be actuated in any other suitable fashion.
  • jaws (42, 44) may be actuated and thus closed by longitudinal translation of a firing beam (60), such that actuator rods/cables/etc. may simply be eliminated in
  • first jaw (42) defines a longitudinally extending elongate slot (46); while second jaw (44) also defines a longitudinally extending elongate slot (48).
  • first jaw (42) presents a first electrode surface (50); while the underside of second jaw (44) presents a second electrode surface (52).
  • Electrode surfaces (50, 52) are in communication with an electrical source (80) via one or more conductors (not shown) that extend along the length of shaft (30).
  • Electrical source (80) is operable to deliver RF energy to first electrode surface (50) at a first polarity and to second electrode surface (52) at a second (opposite) polarity, such that RF current flows between electrode surfaces (50, 52) and thereby through tissue captured between jaws (42, 44).
  • firing beam (60) serves as an electrical conductor that cooperates with electrode surfaces (50, 52) (e.g., as a ground return) for delivery of bipolar RF energy captured between jaws (42, 44).
  • Electrical source (80) may be external to electrosurgical instrument (10) or may be integral with electrosurgical instrument (10) (e.g., in handpiece (20), etc.), as described in one or more references cited herein or otherwise.
  • a controller (82) regulates delivery of power from electrical source (80) to electrode surfaces (50, 52). Controller (82) may also be external to electrosurgical instrument (10) or may be integral with electrosurgical instrument (10) (e.g., in handpiece (20), etc.), as described in one or more references cited herein or otherwise. It should also be understood that electrode surfaces (50, 52) may be provided in a variety of alternative locations, configurations, and relationships.
  • first jaw (42) includes a longitudinally extending recess (58) adjacent to slot (46); while the upper side of second jaw (44) includes a longitudinally extending recess (58) adjacent to slot (48).
  • FIG. 2 shows the upper side of first jaw (42) including a plurality of teeth serrations (46).
  • the lower side of second jaw (44) may include complementary serrations that nest with serrations (46), to enhance gripping of tissue captured between jaws (42, 44) without necessarily tearing the tissue.
  • FIG. 3 shows an example of serrations (46) in first jaw (42) as mainly recesses; with serrations (48) in second jaw (44) as mainly protrusions.
  • serrations (46, 48) may take any other suitable form or may be simply omitted altogether. It should also be understood that serrations (46, 48) may be formed of an electrically non-conductive, or insulative, material, such as plastic, glass, and/or ceramic, for example, and may include a treatment such as polytetrafluoroethylene, a lubricant, or some other treatment to substantially prevent tissue from getting stuck to jaws (42, 44).
  • a treatment such as polytetrafluoroethylene, a lubricant, or some other treatment to substantially prevent tissue from getting stuck to jaws (42, 44).
  • shaft (30) and end effector (40) are sized and configured to fit through trocars having various inner diameters, such that electrosurgical instrument (10) is usable in minimally invasive surgery, though of course electrosurgical instrument (10) could also be used in open procedures if desired.
  • shaft (30) and end effector (40) may present an outer diameter of approximately 5 mm.
  • shaft (30) and end effector (40) may present any other suitable outer diameter (e.g., between approximately 2 mm and approximately 20 mm, etc.).
  • either jaw (42, 44) or both of jaws (42, 44) may include at least one port, passageway, conduit, and/or other feature that is operable to draw steam, smoke, and/or other gases/vapors/etc. from the surgical site.
  • a feature may be in communication with a source of suction, such as an external source or a source within handpiece (20), etc.
  • end effector (40) may include one or more tissue cooling features (not shown) that reduce the degree or extent of thermal spread caused by end effector (40) on adjacent tissue when electrode surfaces (50, 52) are activated.
  • tissue cooling features not shown
  • end effector (40) includes one or more sensors (not shown) that are configured to sense a variety of parameters at end effector (40), including but not limited to temperature of adjacent tissue, electrical resistance or impedance of adjacent tissue, voltage across adjacent tissue, forces exerted on jaws (42, 44) by adjacent tissue, etc.
  • end effector (40) may include one or more positive temperature coefficient (PTC) thermistor bodies (54, 56) (e.g., PTC polymer, etc.), located adjacent to electrodes (50, 52) and/or elsewhere.
  • PTC positive temperature coefficient
  • Controller (82) may process such data in a variety of ways.
  • controller (82) may modulate or otherwise change the RF energy being delivered to electrode surfaces (50, 52), based at least in part on data acquired from one or more sensors at end effector (40).
  • controller (82) may alert the user to one or more conditions via an audio and/or visual feedback device (e.g., speaker, lights, display screen, etc.), based at least in part on data acquired from one or more sensors at end effector (40).
  • an audio and/or visual feedback device e.g., speaker, lights, display screen, etc.
  • some kinds of sensors need not necessarily be in communication with controller (82), and may simply provide a purely localized effect at end effector (40).
  • a PTC thermistor bodies (54, 56) at end effector (40) may automatically reduce the energy delivery at electrode surfaces (50, 52) as the temperature of the tissue and/or end effector (40) increases, thereby reducing the likelihood of overheating.
  • a PTC thermistor element is in series with power source (80) and electrode surface (50, 52); and the PTC thermistor provides an increased impedance (reducing flow of current) in response to temperatures exceeding a threshold.
  • electrode surfaces (50, 52) may be used as sensors (e.g., to sense tissue impedance, etc.).
  • electrosurgical instrument (10) of the present example includes a firing beam (60) that is longitudinally movable along part of the length of end effector (40).
  • Firing beam (60) is coaxially positioned within shaft (30), extends along the length of shaft (30), and translates longitudinally within shaft (30) (including articulation section (36) in the present example), though it should be understood that firing beam (60) and shaft (30) may have any other suitable relationship.
  • Firing beam (60) includes a sharp distal blade (64), an upper flange (62), and a lower flange (66). As best seen in FIG.
  • distal blade (64) extends through slots (46, 48) of jaws (42, 44), with upper flange (62) being located above jaw (44) in recess (59) and lower flange (66) being located below jaw (42) in recess (58).
  • the configuration of distal blade (64) and flanges (62, 66) provides an "I-beam" type of cross section at the distal end of firing beam (60). While flanges (62, 66) extend longitudinally only along a small portion of the length of firing beam (60) in the present example, it should be understood that flanges (62, 66) may extend longitudinally along any suitable length of firing beam (60).
  • flanges (62, 66) are positioned along the exterior of jaws (42, 44), flanges (62, 66) may alternatively be disposed in corresponding slots formed within jaws (42, 44).
  • each jaw (42, 44) may define a "T"-shaped slot, with parts of distal blade (64) being disposed in one vertical portion of each "T"-shaped slot and with flanges (62, 66) being disposed in the horizontal portions of the "T"-shaped slots.
  • Distal blade (64) is substantially sharp, such that distal blade (64) will readily sever tissue that is captured between jaws (42, 44). Distal blade (64) is also electrically grounded in the present example, providing a return path for RF energy as described elsewhere herein. In some other versions, distal blade (64) serves as an active electrode. In addition or in the alternative, distal blade (64) may be selectively energized with ultrasonic energy (e.g., harmonic vibrations at approximately 55.5 kHz, etc.).
  • ultrasonic energy e.g., harmonic vibrations at approximately 55.5 kHz, etc.
  • firing beam (60) provides closure of jaws (42, 44) as firing beam (60) is advanced distally.
  • flange (62) urges jaw (44) pivotally toward jaw (42) as firing beam (60) is advanced from a proximal position ( FIGS. 1-3 ) to a distal position ( FIG. 4 ), by bearing against recess (59) formed in jaw (44).
  • This closing effect on jaws (42, 44) by firing beam (60) may occur before distal blade (64) reaches tissue captured between jaws (42, 44).
  • Such staging of encounters by firing beam (60) may reduce the force required to squeeze grip (24) to actuate firing beam (60) through a full firing stroke.
  • firing beam (60) may have already overcome an initial resistance required to substantially close jaws (42, 44) on tissue before encountering resistance from severing the tissue captured between jaws (42, 44).
  • any other suitable staging may be provided.
  • flange (62) is configured to cam against a ramp feature at the proximal end of jaw (44) to open jaw (42) when firing beam (60) is retracted to a proximal position and to hold jaw (42) open when firing beam (60) remains at the proximal position.
  • This camming capability may facilitate use of end effector (40) to separate layers of tissue, to perform blunt dissections, etc., by forcing jaws (42, 44) apart from a closed position.
  • jaws (42, 44) are resiliently biased to an open position by a spring or other type of resilient feature.
  • jaws (42, 44) close or open as firing beam (60) is translated in the present example
  • other versions may provide independent movement of jaws (42, 44) and firing beam (60).
  • one or more cables, rods, beams, or other features may extend through shaft (30) to selectively actuate jaws (42, 44) independently of firing beam (60).
  • Such jaw (42, 44) actuation features may be separately controlled by a dedicated feature of handpiece (20).
  • jaw actuation features may be controlled by trigger (24) in addition to having trigger (24) control firing beam (60).
  • firing beam (60) may be resiliently biased to a proximal position, such that firing beam (60) retracts proximally when a user relaxes their grip on trigger (24).
  • end effector (40) is inserted into a patient via a trocar.
  • Articulation section (36) is substantially straight when end effector (40) and part of shaft (30) are inserted through the trocar.
  • Articulation control (28) may then be manipulated to pivot or flex articulation section (36) of shaft (30) in order to position end effector (40) at a desired position and orientation relative to an anatomical structure within the patient.
  • Two layers of tissue of the anatomical structure are then captured between jaws (42, 44) by squeezing trigger (24) toward pistol grip (22).
  • Such layers of tissue may be part of the same natural lumen defining anatomical structure (e.g., blood veseel, portion of gastrointestinal tract, portion of reproductive system, etc.) in a patient.
  • one tissue layer may comprise the top portion of a blood vessel while the other tissue layer may comprise the bottom portion of the blood vessel, along the same region of length of the blood vessel (e.g., such that the fluid path through the blood vessel before use of electrosurgical instrument (10) is perpendicular to the longitudinal axis defined by end effector (40), etc.).
  • the lengths of jaws (42, 44) may be oriented perpendicular to (or at least generally transverse to) the length of the blood vessel.
  • flanges (62, 66) cammingly act to pivot jaw (44) toward jaw (44) when firing beam (60) is actuated distally by squeezing trigger (24) toward pistol grip (22).
  • firing beam (60) continues to advance distally by the user squeezing trigger (24) toward pistol grip (22).
  • distal blade (64) simultaneously severs the clamped tissue layers, resulting in separated upper layer portions being apposed with respective separated lower layer portions. In some versions, this results in a blood vessel being cut in a direction that is generally transverse to the length of the blood vessel. It should be understood that the presence of flanges (62, 66) immediately above and below jaws (42, 44), respectively, may help keep jaws (42, 44) in a closed and tightly clamping position.
  • flanges (62, 66) may help maintain a significantly compressive force between jaws (42, 44).
  • electrode surfaces (50, 52) are activated with bipolar RF energy by the user depressing activation button (26).
  • electrodes (50, 52) are selectively coupled with power source (80) (e.g., by the user depressing button (26), etc.) such that electrode surfaces (50, 52) of jaws (42, 44) are activated with a common first polarity while firing beam (60) is activated at a second polarity that is opposite to the first polarity.
  • a bipolar RF current flows between firing beam (60) and electrode surfaces (50, 52) of jaws (42, 44), through the compressed regions of severed tissue layer portions.
  • electrode surface (50) has one polarity while electrode surface (52) and firing beam (60) both have the other polarity.
  • bipolar RF energy delivered by power source (80) ultimately thermally welds the tissue layer portions on one side of firing beam (60) together and the tissue layer portions on the other side of firing beam (60) together.
  • electrode surfaces (50, 52) can denature the collagen within the tissue layer portions and, in cooperation with clamping pressure provided by jaws (42, 44), the denatured collagen can form a seal within the tissue layer portions.
  • the severed ends of the natural lumen defining anatomical structure are hemostatically sealed shut, such that the severed ends will not leak bodily fluids.
  • electrode surfaces (50, 52) may be activated with bipolar RF energy before firing beam (60) even begins to translate distally and thus before the tissue is even severed. For instance, such timing may be provided in versions where button (26) serves as a mechanical lockout relative to trigger (24) in addition to serving as a switch between power source (80) and electrode surfaces (50, 52).
  • electrosurgical instrument (10) While several of the teachings below are described as variations to electrosurgical instrument (10), it should be understood that various teachings below may also be incorporated into various other types of devices. By way of example only, in addition to being readily incorporated into electrosurgical instrument (10), various teachings below may be readily incorporated into the devices taught in any of the references cited herein, other types of electrosurgical devices, surgical staplers, surgical clip appliers, and tissue graspers, among various other devices. Other suitable devices into which the following teachings may be incorporated will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • Articulation section (36) of shaft (30) may take a variety of forms.
  • articulation section (36) may be configured in accordance with one or more teachings of U.S. Pub. No. 2012/0078247 , entitled “Articulation Joint Features for Articulating Surgical Device,” published March 29, 2012.
  • articulation section (36) may be configured in accordance with one or more teachings of U.S. Pub. No. 2012/0078248 , entitled “Articulation Joint Features for Articulating Surgical Device,” published March 29, 2012.
  • articulation section may be configured in accordance with the teachings of at least one other of the references cited herein.
  • Various other suitable forms that articulation section (36) may take will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • some versions of handpiece (20) include an articulation control (28), which is operable to control articulation section (36) of shaft (30) to thereby selectively position end effector (40) at various angles relative to the longitudinal axis defined by sheath (32).
  • articulation control (28) and other components of handpiece (20) may take will be described in greater detail below, while further examples will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • some merely illustrative alternative examples of articulation control (28) are disclosed in U.S. Pub. No. 2012/0078243 , entitled “Control Features for Articulating Surgical Device,” published March 29, 2012; and in U.S. Pub. No. 2012/0078244 , entitled “Control Features for Articulating Surgical Device,” published March 29, 2012.
  • FIG. 5 depicts an exemplary electrosurgical instrument (100) that includes a handpiece (120), a shaft (130) extending distally from handpiece (120), and an end effector (140) disposed at a distal end of shaft (130).
  • Handpiece (120) of the present example includes a pistol grip (122), a pivoting trigger (124), an activation button (126), and a rotary articulation knob (128).
  • Trigger (124) is pivotable toward and away from pistol grip (122) to selectively actuate end effector (140) as described above and as described in one or more of the references cited herein.
  • Activation button (126) is operable to selectively activate RF circuitry that is in communication with end effector (140), as also described above and as described in one or more reference cited herein.
  • activation button (126) also serves as a mechanical lockout against trigger (124), such that trigger (124) cannot be fully actuated unless button (126) is being pressed simultaneously. Examples of how such a lockout may be provided are disclosed in one or more of the references cited herein. It should be understood that pistol grip (122), trigger (124), and button (126) may be modified, substituted, supplemented, etc. in any suitable way, and that the descriptions of such components herein are merely illustrative.
  • Articulation knob (128) of the present example is operable to selectively control articulation section (136) of shaft (130), as will be described in greater detail below.
  • Shaft (130) of the present example includes an outer sheath (132), an articulation section (136) at the distal end of sheath (132), and a cutting member driver tube (138) that is slidably and coaxially disposed within sheath (132).
  • Cutting member driver tube (138) is secured to a driver block (139), which is further secured to a cutting member (146) of end effector (140).
  • Cutting member driver tube (138) is movable longitudinally to drive driver block (139) longitudinally, to thereby move cutting member (146) longitudinally.
  • Cutting member (146) is essentially equivalent to firing beam (60) described above.
  • the proximal portion (148) of end effector (140) includes an insert (not shown) that defines a channel containing the part of cutting member (146) that extends through proximal portion (148). This channel is configured to permit cutting member (146) to readily translate relative to the insert, while also preventing cutting member (146) from buckling within the insert when cutting member (146) encounters a load during distal advancement of cutting member (146).
  • driver tube (138) is advanced distally by squeezing trigger (124) toward pistol grip (122); while driver tube (138) is retracted proximally by releasing trigger (124) and/or by actively moving trigger (124) away from pistol grip (122).
  • a yoke (125) couples trigger (124) with driver tube (138).
  • cutting member (146) may be moved in any other suitable fashion.
  • Articulation section (136) of the present example is operable to selectively position end effector (140) at various angles relative to the longitudinal axis defined by sheath (132).
  • end effector (140) may be configured in accordance with end effector (40) described above, in accordance with the teachings of various references cited herein, and/or in any other suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • shaft (130) is also rotatable about the longitudinal axis defined by sheath (132), relative to handpiece (120), via a knob (134). Such rotation may provide rotation of end effector (140) and shaft (130) unitarily.
  • knob (134) is operable to rotate end effector (140) without rotating any portion of shaft (130) that is proximal of articulation section (136).
  • electrosurgical instrument (100) may include one rotation control that provides rotatability of shaft (130) and end effector (140) as a single unit; and another rotation control that provides rotatability of end effector (140) without rotating any portion of shaft (130) that is proximal of section (136).
  • Other suitable rotation schemes will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • rotatable features may simply be omitted if desired.
  • FIGS. 6-12 show various components of shaft (130) that provide control for articulation of articulation section (136).
  • these components include a separator (150), a first articulation band (160) with an associated drive member (162), and a second articulation band (170) with an associated drive member (172).
  • separator (150) includes an upper lumen (151), a middle lumen (152), and a lower lumen (153).
  • Separator (150) also includes side recesses (154), a distal projection (156), and a gap (158).
  • Separator (150) is disposed within cutting member driver tube (138) and maintains a fixed longitudinal position during operation of instrument (100).
  • separator (150) and outer sheath (132) remain stationary relative to each other and relative to handpiece (120); while cutting member driver tube (138) reciprocates relative to separator (150), outer sheath (132), and handpiece (120).
  • Distal projection (156) is configured to permit translation of driver block (139) substantially free from interference by distal projection (156) or by any other portion of separator (150).
  • separator (150) is formed as two pieces arranged in an end-to-end configuration, with a distal projection from the proximal piece helping to define gap (158).
  • separator (150) may alternatively be formed as a single piece or any other suitable number of pieces.
  • gap (158) may be formed as a cutout from a single piece of material.
  • a wire (900) extends through separator (150) to provide electrical communication to end effector (140).
  • wire (900) extends through middle lumen (152) from the proximal end of separator (150) until wire (900) reaches gap (158).
  • gap (158) wire (900) transitions down to lower lumen (153), and extends through lower lumen (153) until reaching the distal end of separator (150).
  • Wire (900) then extends across articulation section (136) to end effector (140).
  • Wire (900) is thus operable to communicate power from a power source to end effector (140) in accordance with the teachings herein and in accordance with the teachings of various references cited herein.
  • Distal projection (156) protects wire (900) from driver block (139), such that driver block (139) is unable to contact wire (900) regardless of the longitudinal position of driver block (139) along distal projection (156).
  • First articulation band (160) is slidably disposed in one side recess (154) of separator (150) while second articulation band (170) is slidably disposed in the other side recess (154) of separator (150).
  • side recesses (154) include longitudinally extending grooves (155) that are configured to reduce the contact surface area with articulation bands (160, 170), thereby reducing friction between separator (150) and articulation bands (160, 170).
  • Separator (150) may also be formed of a low friction material and/or include a surface treatment to reduce friction.
  • Articulation bands (160, 170) both extend longitudinally along the entire length of shaft (130), including through articulation section (136). As shown in FIG.
  • first articulation band (160) is secured to one side of the proximal portion (148) of end effector (140) at an anchor point.
  • second articulation band (170) is secured to the other side of proximal portion (148) of end effector (140) at an anchor point.
  • rotary articulation knob (128) is operable to selectively advance one articulation band (160, 170) distally while simultaneously retracting the other articulation band (160, 170) proximally, and vice-versa. It should be understood that this opposing translation will cause articulation section (136) to bend, thereby articulating end effector (140). In particular, end effector (140) will deflect toward whichever articulation band (160, 170) is being retracted proximally; and away from whichever articulation band (160, 170) is being advanced distally.
  • drive member (162) is unitarily secured to articulation band (160) and includes a notch (164) extending laterally inwardly.
  • drive member (172) is unitarily secured to articulation band (170) and includes a notch (174) extending laterally inwardly.
  • drive members (162, 164) are spaced and configured such that notches (164, 174) are at different longitudinal positions along the length of separator (150).
  • the proximal portion of cutting member driver tube (138) includes longitudinally extending slots (137).
  • Drive members (162, 172) are slidably disposed in slots (137) and notches (164, 174) are radially positioned outside the outer circumference of cutting member driver tube (138).
  • Slots (137) are configured to enable free translation of cutting member driver tube (138) relative to drive members (162, 172), to thus enable free actuation of cutting member (164) regardless of the articulation state of articulation section (136).
  • slots (137) are configured to enable free translation of drive members (162, 172) relative to cutting member driver tube (138), to thus enable free articulation of articulation section (136) regardless of the longitudinal position of cutting member (164).
  • rotary articulation knob (128) is coaxially positioned about the proximal portion of driver tube (138) and encompasses drive members (162, 172).
  • Articulation knob (128) is oriented perpendicular to the longitudinal axis defined by shaft (130) and is rotatable about the longitudinal axis defined by shaft (130).
  • rotation of articulation knob (128) will cause opposing translation of drive members (162, 172), with the directions of such opposing translations depending on the direction in which articulation knob (128) is rotated, such that rotation of articulation knob (128) will articulate end effector (140).
  • articulation knob (128) includes a first internal threading (180) and a second internal threading (182). Threadings (181, 182) have opposing pitch angles or orientations in this example.
  • first lead screw (183) and a second lead screw (184) are slidably disposed along a pair of pins (123), which are secured to housing (121).
  • lead screws (183, 184) are operable to translate within housing (121) but are prevented from rotating within housing (121).
  • First lead screw (183) includes exterior threading (185) that is engaged with threading (181) of articulation knob (128); while second lead screw (184) includes exterior threading (186) that is engaged with threading (182) of articulation knob (128).
  • the pitch angle of threading (185) complements the pitch angle of threading (181); while the pitch angle of threading (186) complements the pitch angle of threading (182).
  • angles of threading (181, 182, 185, 186) are also configured such that articulation section (136) will be effectively locked in any given articulated position, such that transverse loads on end effector (140) will generally not bend articulation section (136), due to friction between threading (181, 182, 185, 186). In other words, articulation section (136) will only change its configuration when knob (128) is rotated. While the angles of threading may substantially prevent bending of articulation section (136) in response to transverse loads on end effector (140), the angles may still provide ready rotation of articulation knob (128) to translate lead screws (183, 184).
  • the angles of threading (181, 182, 185, 186) may be approximately +/- 2 degrees or approximately +/- 3 degrees. Other suitable angles will be apparent to those of ordinary skill in the art in view of the teachings herein. It should also be understood that threading (181, 182, 185, 186) may have a square or rectangular cross-section or any other suitable configuration.
  • first tensioner gear (191) is threadably engaged with first lead screw (183); while a second tensioner gear (192) is threadably engaged with second lead screw (184).
  • first tensioner gear (191) relative to first lead screw (183) may be adjusted by rotating first tensioner gear (191) relative to first lead screw (183); while the longitudinal position of second tensioner gear (192) relative to second lead screw (184) may be adjusted by rotating second tensioner gear (192) relative to second lead screw (184).
  • first tensioner gear (191) will translate unitarily with first lead screw (183); while second tensioner gear (192) will translate unitarily with second lead screw (184).
  • First tensioner gear (191) is also engaged with a washer (193), which is further engaged with notch (174) of drive member (172).
  • the engagement between washer (193) and drive member (172) is such that washer (193) and drive member (172) will translate together.
  • washer (193) is secured to tensioner gear (191) in such a manner that tensioner gear (191) both pulls washer (193) distally and pushes washer (193) proximally.
  • first lead screw (183) is operable to both push articulation band (170) distally and pull articulation band (170) proximally, depending on which direction knob (128) is rotated.
  • tensioner gear (191) merely abuts washer (193), such that tensioner gear (191) is operable to push washer (193) proximally but cannot pull washer (193) distally.
  • first lead screw (183) is operable to pull articulation band (170) proximally but cannot actively push articulation band (170) distally.
  • first lead screw (183) may simply pull tensioner gear (191) distally to enable articulation band (170), drive member (172), and washer (193) to be driven distally in response to proximal retraction of articulation band (160) as communicated through articulation section (136).
  • Other suitable relationships will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • drive member (172) and/or washer (193) may be rotatable relative to tensioner gear (191), which may permit rotation of shaft (130) by knob (134).
  • tensioner gear (191) may be used to take out any tolerance gaps between drive member (172) and lead screw (183).
  • second tensioner gear (192) is engaged with a washer (194), which is further engaged with notch (164) of drive member (162).
  • the engagement between washer (194) and drive member (162) is such that washer (194) and drive member (162) will translate together.
  • washer (194) is secured to tensioner gear (192) in such a manner that tensioner gear (192) both pulls washer (194) distally and pushes washer (194) proximally.
  • second lead screw (184) is operable to both push articulation band (160) distally and pull articulation band (160) proximally, depending on which direction knob (128) is rotated.
  • tensioner gear (192) merely abuts washer (194), such that tensioner gear (192) is operable to push washer (194) proximally but cannot pull washer (194) distally.
  • second lead screw (184) is operable to pull articulation band (160) proximally but cannot actively push articulation band (160) distally.
  • second lead screw (184) may simply pull tensioner gear (192) distally to enable articulation band (160), drive member (162), and washer (194) to be driven distally in response to proximal retraction of articulation band (170) as communicated through articulation section (136).
  • Other suitable relationships will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • drive member (162) and/or washer (194) may be rotatable relative to tensioner gear (192), which may permit rotation of shaft (130) by knob (134).
  • tensioner gear (192) may be used to take out any tolerance gaps between drive member (162) and lead screw (184).
  • FIGS. 17A-17C show several of the above described components interacting to bend articulation section (136) to articulate end effector (140).
  • articulation (136) is in a substantially straight configuration.
  • knob (128) is rotated, which causes lead screw (183) to translate proximally and lead screw (184) to advance distally.
  • This proximal translation of lead screw (183) pulls articulation band (170) proximally, which causes articulation section (136) to start bending as shown in FIG. 17B .
  • This bending of articulation section (136) pulls articulation band (160) distally.
  • knob (128) includes a visual indicator that is associated with articulation section (136) being in a substantially straight configuration.
  • a visual indicator may align with a corresponding visual indicator on housing (121) of handpiece (120).
  • the user may observe such indicators to confirm whether articulation section (136) has in fact reached a substantially straight configuration.
  • this may be done right before instrument (100) is withdrawn from a trocar to reduce the likelihood of articulation section (136) snagging on a distal edge of the trocar.
  • such indicators are merely optional.
  • manufacturing inconsistencies may result in articulation bands (160, 170) having slightly different lengths.
  • Such inconsistencies may result in lost motion or slop in the operation of the articulation features of instrument (100).
  • tensioner gears (191, 192) may be rotated relative to lead screws (183, 184) to adjust the longitudinal position of drive members (162, 172) relative to lead screws (183, 184). For instance, if there is insufficient tension in articulation band (170), tensioner gear (191) may be rotated to drive washer (193) and drive member (172) proximally until articulation band (170) reaches a sufficient degree of tension. Similarly, if there is insufficient tension in articulation band (160), tensioner gear (192) may be rotated to drive washer (195) and drive member (162) proximally until articulation band (160) reaches a sufficient degree of tension. Lead screws (183, 184) may remain substantially stationary during such adjustments. Articulation section (136) may remain substantially straight during such adjustments and may even be held substantially straight during such adjustments.
  • tensioner gears (191, 192) are rotated manually. In some other versions, tensioner gears (191, 192) are rotated automatically by a rack or other gear.
  • a control logic may monitor the load on a motor that is being used to drive a calibrating rack or gear that is engaged with tensioner gear (191, 192), and may automatically stop driving such a rack or gear when the load reaches a threshold associated with proper tensioning of band (160, 170).
  • tensioner gears (191, 192) may be rotated until such gaps are closed and sufficient contact is made between previously gapped components.
  • tensioner gears (191, 192) may be automatically stopped when the proximal ends of bands (160, 170) and/or drive members (162, 172) reach a certain point.
  • tensioner gears (191, 192) may be adjusted will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • tensioner gears (191, 192) may be heat staked, glued, welded, or otherwise bonded to the respective lead screws (183, 184) when the gaps between drive members (162, 172) and their respective washers (193, 194) reach zero. Such bonding may prevent subsequent movement of tensioner gears (191, 192) relative to their respective lead screws (183, 184).
  • bands (160, 170) may be addressed at the distal ends of bands (160, 170). For instance, before the distal ends of bands (160, 170) are secured to the proximal portion (148) of end effector (140), articulation section (136) may be held in a straight configuration and bands (160, 170) may be pulled distally to remove any slack in bands (160, 170). With bands (160, 170) both being in tension, bands (160, 170) may then be welded or otherwise secured to proximal portion (148) of end effector (140).
  • FIG. 18 depicts an exemplary alternative electrosurgical instrument (200) that includes a handpiece (220), a shaft (230) extending distally from handpiece (220), and an end effector (not shown) disposed at a distal end of shaft (230).
  • the end effector of instrument (200) is substantially identical to end effector (140) of instrument (100) described above.
  • Handpiece (220) of the present example includes a pistol grip (222), a pivoting trigger (224), an activation button (226), and a rotary articulation knob (228).
  • Trigger (224) is pivotable toward and away from pistol grip (222) to selectively actuate the end effector as described above and as described in one or more of the references cited herein.
  • Activation button (226) is operable to selectively activate RF circuitry that is in communication with the end effector, as also described above and as described in one or more reference cited herein.
  • activation button (226) also serves as a mechanical lockout against trigger (224), such that trigger (224) cannot be fully actuated unless button (226) is being pressed simultaneously. Examples of how such a lockout may be provided are disclosed in one or more of the references cited herein. It should be understood that pistol grip (222), trigger (224), and button (226) may be modified, substituted, supplemented, etc. in any suitable way, and that the descriptions of such components herein are merely illustrative.
  • Articulation knob (228) of the present example is operable to selectively control an articulation section (not shown) of shaft (230), as will be described in greater detail below.
  • the articulation section of shaft (230) is substantially identical to articulation section (136) of instrument (100) described above.
  • Shaft (230) of the present example includes an outer sheath (232), the above-noted articulation section (not shown) at the distal end of sheath (232), and a cutting member driver tube (238) that is slidably and coaxially disposed within sheath (232).
  • Cutting member driver tube (238) is secured to a driver block (not shown, but substantially similar to driver block (139) described above), which is further secured to a cutting member (not shown, but substantially similar to cutting member (146) described ablve) of the above-noted end effector.
  • Cutting member driver tube (238) is movable longitudinally to drive the driver block longitudinally, to thereby move the cutting member longitudinally.
  • driver tube (238) is advanced distally by squeezing trigger (224) toward pistol grip (222); while driver tube (238) is retracted proximally by releasing trigger (224) and/or by actively moving trigger (224) away from pistol grip (222).
  • a yoke (225) couples trigger (224) with driver tube (238).
  • the cutting member may be moved in any other suitable fashion.
  • the articulation section of the present example is operable to selectively position the end effector at various angles relative to the longitudinal axis defined by sheath (232).
  • an articulation section and other components of shaft (230) may take are described in various references cited herein, while further examples will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • the end effector may be configured in accordance with end effector (40, 140) described above, in accordance with the teachings of various references cited herein, and/or in any other suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • FIGS. 18-24 show various components of shaft (230) that provide control for articulation of articulation section (236).
  • these components include a separator (250), a first articulation band (260) with an associated drive member (262), and a second articulation band (270) with an associated drive member (272).
  • Separator (250) of this example is substantially identical to separator (150) described above. However, one difference between separator (250) of this example and separator (150) described above is that separator (250) includes a proximal flange (252) that is engaged with housing (221), to prevent longitudinal movement of separator (250) relative to housing (221), as best seen in FIGS. 19-22 .
  • separator (250) is disposed within cutting member driver tube (238) and maintains a fixed longitudinal position during operation of instrument (200). Thus, separator (250) and outer sheath (232) remain stationary relative to each other and relative to handpiece (220); while cutting member driver tube (238) reciprocates relative to separator (250), outer sheath (232), and handpiece (220).
  • First articulation band (260) is slidably disposed in one side recess of separator (250) while second articulation band (270) is slidably disposed in the other side recess of separator (250).
  • Articulation bands (260, 270) both extend longitudinally along the entire length of shaft (230), including through the articulation section.
  • first articulation band (260) is secured to one side of the proximal portion of the end effector at an anchor point.
  • the distal end of second articulation band (270) is secured to the other side of the proximal portion of the end effector at an anchor point.
  • rotary articulation knob (228) is operable to selectively advance one articulation band (260, 270) distally while simultaneously retracting the other articulation band (260, 270) proximally, and vice-versa. It should be understood that this opposing translation will cause the articulation section to bend, thereby articulating the end effector. In particular, the end effector will deflect toward whichever articulation band (260, 270) is being retracted proximally; and away from whichever articulation band (260, 270) is being advanced distally.
  • drive member (262) is unitarily secured to articulation band (260) and defines a lateral notch (264).
  • drive member (272) is unitarily secured to articulation band (270) and defines a lateral notch (274).
  • Drive members (262, 264) are spaced and configured such that notches (264, 274) are at different longitudinal positions along the length of separator (250).
  • the proximal portion of cutting member driver tube (238) includes longitudinally extending slots (237).
  • Drive members (262, 272) are slidably disposed in slots (237) and notches (264, 274) are radially positioned outside the outer circumference of cutting member driver tube (238).
  • Slots (237) are configured to enable free translation of cutting member driver tube (238) relative to drive members (262, 272), to thus enable free actuation of the cutting member regardless of the articulation state of the articulation section.
  • slots (237) are configured to enable free translation of drive members (262, 272) relative to cutting member driver tube (238), to thus enable free articulation of the articulation section regardless of the longitudinal position of the cutting member.
  • rotary articulation knob (228) is coaxially positioned about the proximal portion of driver tube (238) and encompasses drive members (262, 272).
  • Articulation knob (228) is formed by a first knob half (228a) and a second knob half (228b). Articulation knob (228) is oriented perpendicular to the longitudinal axis defined by shaft (230) and is rotatable about the longitudinal axis defined by shaft (230).
  • articulation knob (228) includes a first internal threading (280) and a second internal threading (282). Threadings (281, 282) have opposing pitch angles or orientations in this example. It should be understood that threading (281) in first knob half (228a) is continuous with identical threading (281) in second knob half (228b) when halves (228a, 228b) are assembled together to form articulation knob (228). Likewise, threading (282) in first knob half (228a) is continuous with identical threading (282) in second knob half (228b) when halves (228a, 228b) are assembled together to form articulation knob (228).
  • an undercut in each section of threading (281, 282) is removed in order to facilitate manufacture of knob halves (228a, 228b) using injection molding processes.
  • knob halves (228a, 228b) may be made using any other suitable process(es) and/or undercut in threading (281, 282) need not necessarily be removed.
  • first lead screw (283) and a second lead screw (284) are slidably disposed along a pair of pins (223), which are secured to housing (221).
  • Lead screws (283, 284) are thus operable to translate within housing (221) along pins (223); but are prevented from rotating within housing (221).
  • First lead screw (283) includes exterior threading (285) that is engaged with threading (281) of articulation knob (228); while second lead screw (284) includes exterior threading (286) that is engaged with threading (282) of articulation knob (228).
  • the pitch angle of threading (285) complements the pitch angle of threading (281); while the pitch angle of threading (286) complements the pitch angle of threading (282).
  • Threading (281, 282) may include hard stops at each end of threading (281, 282), to limit the longitudinal travel of lead screws (283, 284), which may in turn limit the degree of articulation that may be attained in the articulation section of shaft (230).
  • the articulation section of shaft (230) is in a substantially straight configuration when lead screws (283, 284) are located at the approximate longitudinal center region of the corresponding threading (281, 282), such that rotation of knob (282) in a clockwise direction from this "home” position will deflect the end effector in a first direction away from the longitudinal axis of shaft (230); while rotation of knob (282) in a counterclockwise direction from the "home” position will deflect the end effector in a second direction away from the longitudinal axis of shaft (230).
  • the articulation section of shaft (230) is in a substantially straight configuration when lead screws (283, 284) are located at opposite ends of the corresponding threading (281, 282), such that knob (282) will only rotate in one direction from this "home” position.
  • the angles of threading (281, 282, 285, 286) may be configured such that the articulation section will be effectively locked in any given articulated position, such that transverse loads on the end effector will generally not bend the articulation section, due to friction between threading (281, 282, 285, 286).
  • threading (281, 282, 285, 286) is configured such that when a load is applied to the end effector, engagement in between threading (281, 282) and respective threading (285, 286) will not slip and cause the articulation state of the end effector to change.
  • the articulation control assembly may thus be self-locking such that the articulation section will only change its configuration when knob (228) is rotated.
  • angles of threading may substantially prevent bending of the articulation section in response to transverse loads on the end effector, the angles may still provide ready rotation of articulation knob (228) to translate lead screws (283, 284).
  • the angles of threading (281, 282, 285, 286) may be approximately +/- 2 degrees or approximately +/- 3 degrees. Other suitable angles will be apparent to those of ordinary skill in the art in view of the teachings herein. It should also be understood that threading (281, 282, 285, 286) may have a square or rectangular cross-section or any other suitable configuration.
  • first rivet member (291) is engaged with first lead screw (283); while a second rivet member (292) is engaged with second lead screw (284).
  • First rivet member (291) is disposed in notch (274) of drive member (272).
  • the engagement between first rivet member (291) and drive member (272) is such that first rivet member (291) and drive member (272) will translate together.
  • first rivet member (291) both pulls drive member (272) proximally and pushes drive member (272) distally, depending on the direction in which knob (228) is rotated.
  • first lead screw (283) is operable to both push articulation band (270) distally and pull articulation band (270) proximally, depending on which direction knob (228) is rotated, via first rivet member (291).
  • drive member (272) and/or first rivet member (291) may be rotatable relative to first lead screw (283), which may permit rotation of shaft (230) by knob (234) as described below.
  • second rivet member (292) is engaged with second lead screw (284).
  • Second rivet member (292) is disposed in a notch (264) of drive member (262).
  • the engagement between second rivet member (292) and drive member (262) is such that second rivet member (292) and drive member (262) will translate together.
  • second rivet member (292) both pulls drive member (262) proximally and pushes drive member (262) distally, depending on the direction in which knob (228) is rotated.
  • second lead screw (284) is operable to both push articulation band (260) distally and pull articulation band (260) proximally, depending on which direction knob (228) is rotated.
  • the opposing orientations of threading (285, 286) provide simultaneous opposing translation of rivet members (291, 292) (and simultaneous opposing translation of lead screws (283, 284)), thereby providing simultaneous opposing translation of drive members (262, 272). While rivet member (291) pushes distally on the distal end of the notch in drive member (272), rivet member (292) pushes proximally on the proximal end of the notch in drive member (262). Likewise, while rivet member (292) pushes distally on the distal end of the notch in drive member (262), rivet member pushes proximally on the proximal end of the notch in drive member (272).
  • drive member (262) and/or second rivet member (292) may be rotatable relative to second lead screw (284), which may permit rotation of shaft (230) by knob (234) as described below.
  • articulation knob (228) is formed by a first knob half (228a) and a second knob half (228b).
  • forces exerted back on knob halves (228a, 228b) by lead screws (283, 284) may tend to urge knob halves (228a, 228b) to separate from each other, particularly when knob (228) is being rotated to articulate the articulation section of shaft (230) and tissue and/or friction are/is providing significant resistance to such articulation.
  • a pair of containment rings (300, 310) are positioned at each end of assembled knob (228). Containment rings (300, 310) are configured to substantially prevent knob halves (228a, 228b) from separating from each other.
  • Containment ring (300) includes a flange (302) and a cylindraceous portion (304).
  • cylindraceous portion (304) include a series of notches (306) angularly arrayed about the circumference of cylindraceous portion (304).
  • Cylindraceous portion (304) is configured to encompass complementary cylindraceous portions (320a, 320b) formed by knob halves (228a, 228b).
  • Cylindraceous portions (320a, 320b) include axially extending protrusions (322a, 322b) that are received in notches (306) of cylindraceous portion (304) when knob (228) is assembled with containment ring (300). This engagement provides unitary rotation of containment ring (300) with knob halves (228a, 228b).
  • flange (302) of containment ring (300) engages bosses (227) of housing (221). Bosses (227) restrain containment ring (300) in the radial and axial directions, but permit rotation of containment ring (300) relative to housing (221).
  • flange (302) and/or the entire containment ring (300) comprises a low friction material to minimize frictional resistance due to contact between flange (302) and bosses (227).
  • flange (302) may be formed of a low friction material or may be coated with a low friction material.
  • bosses (227) may comprise a low friction material.
  • flange (302) and bosses (227) may provide a relatively low friction bearing surface as an interface between knob (228) and housing (221).
  • flange (302), the entire containment ring (300), and/or bosses (227) will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • Containment ring (310) is configured similar to containment ring (300).
  • containment ring (310) includes a flange (312) and a cylindraceous portion (314).
  • cylindraceous portion (314) include a series of notches (316) angularly arrayed about the circumference of cylindraceous portion (314).
  • assembled knob (228) defines an annular recess (330) that includes a plurality of radially extending ribs (332).
  • Annular recess (330) is configured to receive cylindraceous portion (314) of containment ring (310), with ribs (332) being received in notches (316). This engagement provides unitary rotation of containment ring (310) with knob halves (228a, 228b).
  • flange (312) of containment ring (310) engages bosses (229) of housing (221).
  • Bosses (229) restrain containment ring (310) in the radial and axial directions, but permit rotation of containment ring (310) relative to housing (221).
  • flange (312) and/or the entire containment ring (310) comprises a low friction material to minimize frictional resistance due to contact between flange (312) and bosses (229).
  • flange (312) may be formed of a low friction material or may be coated with a low friction material.
  • bosses (229) may comprise a low friction material.
  • flange (312) and bosses (229) may provide a relatively low friction bearing surface as an interface between knob (228) and housing (221).
  • Various suitable materials that may be used for flange (312), the entire containment ring (310), and/or bosses (229) will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • knob (228) is formed of two halves (228a, 228b) in the present example, it should be understood that any suitable number of pieces may be used to form knob, including just one piece or three or more pieces. In versions where three or more pieces are held together, containment rings (300, 310) may substantially hold such pieces together in accordance with the teachings above.
  • a marking may be provided on the exterior of housing (221) and/or on the exterior of knob (228).
  • housing (221) and knob (228) may include complementary arrows that align when the articulation section of shaft (230) is in a straight configuration.
  • the articulation section of shaft (230) may include a high-contrast line or other visual indicator that may enhance visualization of the degree of articulation of the articulation section.
  • a high-contrast line may make it easier to see how straight or bent the articulation section is, since the line will bend or straighten in accordance with the articulation state of the articulation section.
  • Providing a line or other marking on the articulation section may facilitate viewing of the marking within the image provided by an endoscopic camera, such that the surgeon need not look away from the surgical field presented on a screen coupled with the endoscopic camera in order to determine the degree of articulation of the articulation section.
  • Other suitable ways of providing visual feedback to indicate articulation states will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • Instrument (200) of the present example includes features for providing audible and tactile feedback relating to the articulation state of the articulation section of shaft (230).
  • a detent arm (350) is secured to housing (221).
  • Detent arm (350) includes a detent pad (352) that has a protrusion (360) that is configured to snap into a longitudinal recess (340) formed in cylindraceous portion (320a) of knob half (228a).
  • recess (340) is only provided in knob half (228a), and knob half (228b) does not include any similar recess.
  • Detent arm (350) is resiliently biased to urge detent pad (352) radially inwardly toward knob half (228a).
  • Recess (340) is positioned such that the protrusion of detent pad (352) will snap into recess (340) when the articulation section of shaft (230) is in a substantially straight configuration.
  • knob (228) is rotated to articulate the articulation section, detent arm (350) will deform and detent pad (352) will be deflected away from recess (340).
  • detent arm (350) will effectively pivot at a bent portion (354) of detent arm (350), which is adjacent to housing (221).
  • protrusion (360) includes an upper angled surface (362) and a lower angled surface (364).
  • Angled surfaces (362, 364) are configured to provide a generally smooth transition for protrusion (360) into and out of recess (340).
  • angled surfaces (362, 364) are substantially symmetric, such that angled surfaces (362, 364) define complementary angles with detent arm (350).
  • angled surfaces (362, 364) are asymmetric.
  • upper surface (362) defines an angle with detent arm (350) that is greater than the angle defined between lower surface (364) and detent arm (350). In other words, upper surface (362) is at a more obtuse angle than lower surface (364).
  • the asymmetry of surfaces (362, 364) in the present example may provide a substantially symmetric force profile when knob (228) is initially rotated to the left (counterclockwise) or right (clockwise) from the home position (i.e., from the position where protrusion (360) is disposed in recess (340)).
  • symmetric surfaces (362, 364) may in fact provide greater resistance to initial left (counterclockwise) rotation of knob (228) than the resistance provided to initial right (clockwise) rotation of knob (228).
  • orienting upper surface (362) at a more obtuse angle will deflect the forces against surface (362) further away from the pivot provided by bent portion (354) when knob (228) is initially rotated to the left (counterclockwise).
  • arrow (365) shows force exerted by cylindraceous portion (320a) at recess (340) against lower surface (364) when knob (228) is initially rotated to the right (clockwise).
  • Arrow (363) shows force exerted by cylindraceous portion (320a) at recess (340) against upper surface (362) when knob (228) is initially rotated to the left (counterclockwise).
  • Arrow (363) is directed further away from the pivot provided by bent portion (354) than it would otherwise be if upper surface (362) were symmetric with lower surface (364).
  • the angle of upper surface (362) in the present example is selected to provide a substantially equal resistance force to initial rotation of knob (228) from the home position in the left (counterclockwise) direction as the resistance force encountered with initial rotation of knob (228) from the home position in the right (clockwise) direction.
  • Other suitable configurations for protrusion (360) will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • symmetry/asymmetry of surfaces (362, 364) may have a negligible effect on rotation of knob (228) once knob (228) has substantially left the home position (e.g., when protrusion (360) is completely displaced from recess (340)).
  • Detent arm (350) and detent pad (352) do not substantially interfere with the free rotation of knob (228); and that the friction between detent pad (352) and cylindraceous portions (320a, 320b) will be negligible when detent pad (352) is disengaged from recess (340).
  • detent pad (352) snaps into engagement with recess (340) (e.g., upon straightening of the articulation section) (e.g., upon straightening of the articulation section)
  • this snapping engagement may heard by the surgeon and/or be felt by the surgeon through handpiece (220).
  • Other suitable ways of providing audible and/or tactile feedback to indicate one or more articulation states will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • the above described articulation control components of instrument (200) may operate in a manner that is substantially similar to the manner that is shown in FIGS. 17A-17C and described above. Alternatively, the above described articulation control components of instrument (200) may operate in some other fashion. It should also be understood that, as described above with respect to instrument (100), manufacturing inconsistencies may be addressed at the distal ends of bands (260, 270). For instance, before the distal ends of bands (260, 270) are secured to the proximal portion of the end effector, the articulation section may be held in a straight configuration and bands (260, 270) may be pulled distally to remove any slack in bands (260, 270).
  • bands (260, 270) may then be welded or otherwise secured to the proximal portion of the end effector.
  • this form of calibration is not limited to instruments (100, 200), such that this form of calibration may be readily applied to various other instruments described herein, among others.
  • Other suitable structures and methods for calibration will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • instrument (10, 100) may provide rotation of an end effector (40, 140) and/or shaft (30, 130) via a knob (34, 134).
  • instrument (200) may provide rotation of its end effector and/or shaft (230), relative to handpiece (220), via a knob (234). Such rotation may provide rotation of the end effector and shaft (230) unitarily.
  • knob (234) is operable to rotate end effector (240) without rotating any portion of shaft (230) that is proximal of the articulation section.
  • electrosurgical instrument (200) may include one rotation control that provides rotatability of shaft (230) and the end effector as a single unit; and another rotation control that provides rotatability of the end effector without rotating any portion of shaft (230) that is proximal of the articulation section.
  • Other suitable rotation schemes will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • instrument (10, 100, 200) may include a pivoting member, sliding member, or some other type of manually movable member that selectively engages a feature that is integral with knob (34, 134, 234) and thereby positively secures the rotational position of knob (34, 134, 234) relative to handpiece (20, 120, 220).
  • a rotational locking feature may be controlled manually from handpiece (20, 120, 220) at any time during use of instrument (10, 100, 200).
  • Various suitable forms that such a manual rotational locking feature may take will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • instrument (10, 100, 200) may be configured to selectively lock the rotational position of shaft (30, 130, 230) and/or end effector (40, 140) whenever the articulation section (36, 136) is in an articulated configuration.
  • such versions of instrument (10, 100, 200) may be configured to permit rotation of shaft (30, 130, 230) and/or end effector (40, 140) only when the articulation section (36, 136) is in a straight configuration. This selective locking of rotation may be automatically based on the articulation state of the articulation section (36, 136), such that the user need not provide a separate rotation lock input.
  • FIGS. 26-28 show an example of features that may be used to provide automatic locking of rotation of shaft (30, 130, 230) and/or the end effector (40, 140) when the articulation section (36, 136) is in a bent configuration. These features nevertheless permit rotation of shaft (30, 130, 230) and/or the end effector (40, 140) when the articulation section (36, 136) is in a straight configuration.
  • FIG. 26 shows an exemplary alternative rivet member (491).
  • This rivet member (491) includes a series of distally extending protrusions (495) angularly arrayed on the distal face (493) of rivet member (491).
  • FIG. 27 shows rivet member (491) positioned in first lead screw (283), though it should be understood that first lead screw (183) may also be fitted with a feature similar to rivet member (491).
  • FIG. 27 also shows second lead screw (284) fitted with a second rivet member (492), which is substantially identical to first rivet member (491).
  • drive member (272) includes a distal lateral protrusion (273) that is spaced distally from rivet member (491) when the articulation section is in a straight configuration.
  • a distal lateral protrusion (263) of drive member (262) is spaced distally from rivet member (492). This spacing permits shaft (230), the end effector, and rotationally linked components including drive members (272, 273) to rotate relative to rivet members (491, 492) and relative to housing (221) when knob (234) is rotated.
  • first lead screw (283) advances distally while second lead screw (284) moves proximally.
  • the distal movement of first lead screw (283) results in entry of lateral protrusion (273) into one of the gaps (497) of rivet member (491).
  • protrusions (495) of rivet member (491) substantially secure the rotational position of lateral protrusion (273).
  • Rivet member (491) thus prevents rotation of shaft (230) and/or the end effector when the articulation section is bent in a first direction.
  • lateral protrusion (273) eventually exits gap (497) and is spaced away from rivet member (491), such that rivet member (491) no longer prevents shaft (230) and/or the end effector from rotating relative to housing (221).
  • second lead screw (284) advances distally while first lead screw (283) moves proximally.
  • the distal movement of second lead screw (284) results in engagement between second rivet member (492) and lateral protrusion (263) in a manner similar to that described above for first rivet member (491) and lateral protrusion (273).
  • Rivet member (492) thus prevents rotation of shaft (230) and/or the end effector when the articulation section is bent in a second direction.
  • rivet members (491, 492) include angularly arrayed recesses in place of protrusions (495), such that rivet members (491, 492) lock rotation of shaft (230) and/or the end effector when a corresponding lateral protrusion (273, 263) is disposed in one of the recesses.
  • lateral protrusions (263, 273) include proximally extending portions to enter the recesses of rivet members (491, 492).
  • instrument (10, 100, 200) may be configured to provide relatively low resistance to rotation of shaft (30, 130, 230) and/or end effector (40, 140) when the articulation section (36, 136) is in a straight configuration; yet provide relatively high resistance to rotation of shaft (30, 130, 230) and/or end effector (40, 140) when the articulation section (36, 136) is in an articulated configuration.
  • Some such versions may still permit rotation of shaft (30, 130, 230) and/or end effector (40, 140) when the articulation section (36, 136) is in an articulated configuration, albeit at a higher resistance than that encountered when the articulation section (36, 136) is in a straight configuration.
  • FIG. 28 shows one merely illustrative example of a feature that may be used to provide varied resistance to rotation of shaft (30, 130, 230) and/or end effector (40, 140).
  • FIG. 28 shows a friction ring (700) positioned in a recess (533) of housing (521). Friction ring (700) is positioned to contact a flange (633) that is unitary with shaft (630).
  • housing (521) may be viewed as being otherwise analogous to housing (121, 221); and shaft (630) analogous to shaft (130, 230), etc.
  • Friction ring (700) may comprise any suitable material, including but not limited to rubber, silicone, isoprene, some other type of elastomeric material, etc.
  • friction ring (700) is compressed between flange (633) and housing (521) by approximately 0.005 inches when the articulation section of shaft (630) is in a substantially straight configuration. This may provide some relatively low resistance to rotation of shaft (630) relative to housing (521).
  • the articulation section of shaft is bent to an articulated configuration (e.g., using one of the articulation assemblies described above, etc.)
  • This may produce backloading on shaft (630), such that shaft (630) is urged proximally even by a slight degree.
  • This may further compress friction ring (700), which may in turn increase the friction between friction ring (700) and flange (633). This increased friction may thereby provide additional resistance to rotation of shaft (630) when the articulation section is bent to an articulated configuration.
  • FIGS. 29-30B show yet another merely illustrative example of features that may be used to provide varied resistance to rotation of shaft (30, 130, 230) and/or end effector (40, 140).
  • FIG. 29 shows a brake disc (800) that includes an integral elastomeric brake pad (810).
  • disc (800) is positioned between lead screws (283, 284), though it should be understood that disc (800) may alternatively be positioned distal to lead screw (283) or proximal to lead screw (284). It should also be understood that lead screw (284) is omitted from FIG. 29 for clarity.
  • Cylindraceous portion (320) of knob (228) Includes an inwardly extending annular flange (321), which is received in an annular recess (802) formed in the outer perimeter of disc (800). This relationship between flange (321) and recess (802) longitudinally restrains disc (800) within cylindraceous portion (320) while still permitting knob (228) to rotate relative to disc (800). Pins (223) pass through disc (800) and prevent disc (800) from rotating.
  • pad (810) has a non-circular profile, with an outer profile resembling that of a nautilus shell.
  • cylindraceous portion (320) includes in inwardly extending cam fin (820) that progressively engages the outer perimeter of pad (810) when knob (228) (and, hence, cylindraceous portion (320)) is rotated.
  • FIG. 30A shows the components positioned when knob (228) is at the home position, with the articulation section of shaft (230) in a substantially straight configuration. At this stage, cam fin (820) is spaced away from pad (810).
  • FIG. 30B shows the components positioned when knob (228) (and, hence, cylindraceous portion (320)) has been rotated to the left (counterclockwise) to bend the articulation section in a first direction.
  • cam fin (820) bears into pad (810). It should be understood that cam fin (820) will begin bearing into pad (810) during part of the transition from the stage shown in FIG. 30A to the stage shown in FIG. 30B , and the degree of this bearing into pad (810) by cam fin (820) will progressively increase as knob (228) continues to rotate. As can also be seen in FIG.
  • FIGS. 29-30B and described above provides increasing resistance to rotation of shaft (230) relative to handpiece (220) in response to left (counterclockwise) rotation of knob (228)
  • similar components may be used to provide increasing resistance to rotation of shaft (230) relative to handpiece (220) in response to right (clockwise) rotation of knob (228).
  • such components may include a brake pad and cam fin that are essentially a mirror image of pad (810) and fin (820) shown in FIGS. 29-30B .
  • pad (810) is provided on the proximal face of disc (800) while a mirror image of pad (810) is provided on the distal face of disc (800).
  • a mirror image of pad (810) is provided on a separate disc.
  • instrument (10, 100, 200) may provide some form of user feedback relating to the rotational position of shaft (230) and/or the end effector.
  • rotation knob (34, 134, 234) and/or shaft (30, 130, 230) and/or the end effector (40, 140) may include one or more markings facilitating visual identification of the rotational position.
  • a user may correlate a marking on a rotation knob (34, 134, 234) with a corresponding marking on shaft (30, 130, 230) and/or the end effector (40, 140) to better understand the orientation of such components with respect to the patient and instrument (10, 100, 200).
  • instrument (10, 100, 200) may facilitate viewing of the marking within the image provided by an endoscopic camera, such that the surgeon need not look away from the surgical field presented on a screen coupled with the endoscopic camera in order to determine the rotational orientation of the end effector.
  • instrument (10, 100, 200) may include a detent feature and/or some other feature(s) that are operable to provide audible and/or tactile feedback to indicate rotational orientation of the end effector.
  • any of the versions of electrosurgical instrument (10) described herein may include various other features in addition to or in lieu of those described above.
  • any of the devices herein may also include one or more of the various features disclosed in U.S. Pub. No. 2012/0078243 , entitled “Control Features for Articulating Surgical Device,” published March 29, 2012; U.S. Pub. No. 2012/0078244 , entitled “Control Features for Articulating Surgical Device,” published March 29, 2012; U.S. Pub. No. 2012/0078247 , entitled “Articulation Joint Features for Articulating Surgical Device,” published March 29, 2012; U.S. Pub. No.
  • any of the devices described herein may be modified to include a motor or other electrically powered device to drive an otherwise manually moved component.
  • Various examples of such modifications are described in U.S. Pub. No. 2012/0116379 , entitled “Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback,” published May 10, 2012.
  • Various other suitable ways in which a motor or other electrically powered device may be incorporated into any of the devices herein will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • any of the devices described herein may be modified to contain most, if not all, of the required components within the medical device itself. More specifically, the devices described herein may be adapted to use an internal or attachable power source instead of requiring the device to be plugged into an external power source by a cable.
  • Various examples of how medical devices may be adapted to include a portable power source are disclosed in U.S. Provisional Application Serial No. 61/410,603, filed November 5, 2010 , entitled “Energy-Based Surgical Instruments,".
  • Various other suitable ways in which a power source may be incorporated into any of the devices herein will be apparent to those of ordinary skill in the art in view of the teachings herein.
  • Embodiments of the present invention have application in conventional endoscopic and open surgical instrumentation as well as application in robotic-assisted surgery. For instance, those of ordinary skill in the art will recognize that various teaching herein may be readily combined with various teachings of U.S. Pat. No. 6,783,524 , entitled “Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument,” published August 31, 2004.
  • Embodiments of the devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. Embodiments may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, embodiments of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, embodiments of the device may be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure.
  • reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
  • a new or used instrument may be obtained and if necessary cleaned.
  • the instrument may then be sterilized.
  • the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag.
  • the container and instrument may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons.
  • the radiation may kill bacteria on the instrument and in the container.
  • the sterilized instrument may then be stored in the sterile container.
  • the sealed container may keep the instrument sterile until it is opened in a medical facility.
  • a device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.

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Claims (13)

  1. Appareil (100), comprenant :
    (a) un effecteur terminal (140) ;
    (b) un arbre allongé (130), l'arbre allongé (130) définissant un axe longitudinal, l'arbre allongé (130) comprenant :
    (i) une extrémité distale, l'effecteur terminal (140) étant positionné au niveau de l'extrémité distale de l'arbre allongé (130),
    (ii) une extrémité proximale, et
    (iii) une section articulation (136), la section articulation (136) pouvant fonctionner pour dévier au moins une partie de l'effecteur terminal (140) à distance de l'axe longitudinal ;
    (c) un ensemble poignée (120) associé à l'extrémité proximale de l'arbre (130), l'ensemble poignée (120) comprenant :
    (i) un élément rotatif (128) possédant des régions de filet opposées (181, 182), et
    (ii) une paire de vis mères (183, 184) en prise avec les régions de filet opposées (181, 182), de sorte que les vis mères (183, 184) puissent fonctionner pour se déplacer par translation simultanément dans des directions opposées en réponse à la rotation de l'élément rotatif (128) ;
    et
    (d) une paire de caractéristiques de commande (162, 172) d'articulation s'étendant à travers l'arbre allongé, les caractéristiques de commande (162, 172) d'articulation étant accouplées aux vis mères (183, 184), les caractéristiques de commande (162, 172) d'articulation étant en outre accouplées à la section articulation (136) de sorte que les caractéristiques de commande (162, 172) d'articulation puissent fonctionner pour entraîner l'articulation de l'effecteur terminal (140) sur la base d'une translation opposée des vis mères (183, 184) ; et comprenant en outre :
    un premier pignon tendeur (191) en prise par filetage avec une première vis de la paire de vis mères (183), de sorte qu'une position longitudinale du premier pignon tendeur (191) par rapport à la première vis mère (183) puisse être ajustée en faisant tourner le premier pignon tendeur (191) par rapport à la première vis mère (183), et
    un second pignon tendeur (192) en prise par filetage avec une seconde vis de la paire de vis mères (184), de sorte qu'une position longitudinale du second pignon tendeur (192) par rapport à la seconde vis mère (184) puisse être ajustée en faisant tourner le second pignon tendeur (192) par rapport à la seconde vis mère (184).
  2. Appareil selon la revendication 1, dans lequel l'ensemble poignée (120) comprend :
    (iii) une section proximale,
    (iv) une section distale, l'arbre allongé (130) s'étendant depuis la section distale de l'ensemble poignée (120), et
    (v) une section intermédiaire positionnée entre la section proximale de l'ensemble poignée (120) et la section distale de l'ensemble poignée (120), et dans lequel
    l'élément rotatif (128) est positionné à l'intérieur de la section intermédiaire, l'élément rotatif (128) pouvant tourner sur un axe de rotation, l'axe de rotation étant parallèle à l'axe longitudinal de l'arbre allongé (130).
  3. Appareil selon la revendication 2, dans lequel les régions de filet opposées (181, 182) comprennent un filetage interne.
  4. Appareil selon la revendication 3, dans lequel :
    le filetage de l'élément rotatif (128) comprend une première région de filet (181) et une seconde région de filet (182), dans lequel la première région de filet (181) et la seconde région de filet (182) ont des pas opposés l'un à l'autre, une première vis de la paire de vis mères (183) est en prise avec la première région de filet (181), et une seconde vis de la paire de vis (184) mères est en prise avec la seconde région de filet (182), et l'élément rotatif (128) peut fonctionner pour simultanément déplacer par translation la première vis mère (183) distalement et déplacer par translation la seconde vis mère (184) proximalement en réponse à la rotation de l'élément rotatif (128) dans une première direction autour de l'axe de rotation ; et
    l'élément rotatif (128) peut en outre fonctionner pour simultanément déplacer par translation la première vis mère (183) proximalement et déplacer par translation la seconde vis mère (184) distalement en réponse à la rotation de l'élément rotatif (128) dans une seconde direction autour de l'axe de rotation.
  5. Appareil selon la revendication 2, dans lequel l'arbre (130) et/ou l'effecteur terminal (140) peuvent tourner par rapport à l'ensemble poignée (120).
  6. Appareil selon la revendication 5, comprenant en outre une caractéristique de verrouillage de rotation (491), dans lequel la caractéristique de verrouillage de rotation est conçue pour sélectivement permettre ou empêcher une rotation de l'arbre (130) ou de l'effecteur terminal (140) par rapport à l'ensemble poignée (120).
  7. Appareil selon la revendication 6, dans lequel la caractéristique de verrouillage de rotation (491) est conçue pour permettre une rotation de l'arbre (130) ou de l'effecteur terminal (140) par rapport à l'ensemble poignée (120) en réponse à la section articulation (136) se trouvant dans une configuration sensiblement rectiligne, dans lequel la caractéristique de verrouillage de rotation (491) est conçue pour empêcher une rotation de l'arbre (130) ou de l'effecteur terminal (140) par rapport à l'ensemble poignée (120) en réponse à la section articulation (136) se trouvant dans une configuration articulée.
  8. Appareil selon la revendication 5, comprenant en outre une caractéristique de résistance à la rotation (800), dans lequel la caractéristique de résistance à la rotation (800) est conçue pour fournir une résistance variable à la rotation de l'arbre (130) ou de l'effecteur terminal (140) par rapport à l'ensemble poignée (120) sur la base d'un état d'articulation de la section articulation (136).
  9. Appareil selon la revendication 8, dans lequel la caractéristique de résistance à la rotation (800) est conçue pour apporter un premier degré de résistance en réponse au fait que la section articulation (136) est sensiblement rectiligne, dans lequel la caractéristique de résistance à la rotation (800) est conçue pour apporter un second degré de résistance en réponse au fait que la section articulation (136) est articulée, le second degré de résistance étant supérieur au premier degré de résistance.
  10. Appareil selon la revendication 8, dans lequel la caractéristique de résistance à la rotation (800) comprend un matériau élastomère (810) conçu pour fournir une résistance au frottement variable à la rotation de l'arbre (130) ou de l'effecteur terminal (140).
  11. Appareil selon la revendication 1, dans lequel l'effecteur terminal (140) comprend :
    (i) une première mâchoire (42), et
    (ii) une seconde mâchoire (44),
    dans lequel la première mâchoire (42) est mobile vers la seconde mâchoire (44) pour serrer un tissu entre les première et seconde mâchoires (42, 44),
    dans lequel au moins une des mâchoires comprend au moins une électrode (50),
    dans lequel l'au moins une électrode (50) peut fonctionner pour distribuer une énergie RF au tissu serré entre les première et seconde mâchoires (42, 44).
  12. Appareil selon la revendication 1, dans lequel l'élément rotatif (128) peut tourner sur un axe de rotation, dans lequel l'axe de rotation est aligné sur l'axe longitudinal de l'arbre allongé (30).
  13. Appareil selon la revendication 1, dans lequel :
    le premier pignon tendeur (191) est en prise avec une première rondelle (193) qui est en outre en prise avec une entaille (174) d'une première des caractéristiques de commande (172) d'articulation, et
    le second pignon tendeur (192) est en prise avec une seconde rondelle (194) qui est en outre en prise avec une entaille (164) d'une seconde des caractéristiques de commande (162) d'articulation.
EP13774849.7A 2012-09-19 2013-09-19 Instrument chirurgical muni d'un ensemble actionneur à double hélice Active EP2897538B1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13/622,735 US9545253B2 (en) 2010-09-24 2012-09-19 Surgical instrument with contained dual helix actuator assembly
PCT/US2013/060537 WO2014047245A1 (fr) 2012-09-19 2013-09-19 Instrument chirurgical muni d'un ensemble actionneur à double hélice

Publications (2)

Publication Number Publication Date
EP2897538A1 EP2897538A1 (fr) 2015-07-29
EP2897538B1 true EP2897538B1 (fr) 2020-02-19

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EP13774849.7A Active EP2897538B1 (fr) 2012-09-19 2013-09-19 Instrument chirurgical muni d'un ensemble actionneur à double hélice

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EP (1) EP2897538B1 (fr)
JP (1) JP6324967B2 (fr)
CN (1) CN104640509B (fr)
BR (1) BR112015006150B1 (fr)
IN (1) IN2015DN01629A (fr)
WO (1) WO2014047245A1 (fr)

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Also Published As

Publication number Publication date
BR112015006150B1 (pt) 2021-11-16
BR112015006150A2 (pt) 2017-07-04
WO2014047245A1 (fr) 2014-03-27
JP6324967B2 (ja) 2018-05-16
JP2015529142A (ja) 2015-10-05
EP2897538A1 (fr) 2015-07-29
CN104640509B (zh) 2017-07-04
IN2015DN01629A (fr) 2015-07-03
CN104640509A (zh) 2015-05-20

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